Abstract
Appendiceal Hemorrhage – A Rare Case of Lower Gastrointestinal Bleeding in a Filipino Male
John Reuel F. Magan /Caroline C. Lim /Arlinking O. Go
Metropolitan Medical Center
Significance: Acute lower gastrointestinal bleeding from the appendix is an uncommon clinical phenomenon with only few cases reported. Therefore, it’s worthy to investigate this rare case of lower GI bleeding to guide us in clinical practice.
Clinical Presentation: A previously healthy 32/male presented with acute painless hematochezia. He passed out several episodes of maroon colored stools approximately 100-200ml per episode on the day of consult. The clinical history, physical examination and initial laboratory tests were unremarkable.
Management: On endoscopy, fresh blood clots filled the entire colon. The terminal ileum was free from blood. After thorough irrigation of the ileocecal region, oozing bright blood from the appendiceal orifice was identified. An emergency diagnostic laparotomy and appendectomy was arranged and revealed a retrocecal appendix with minimal adhesions to right abdominal wall. No rupture, no diverticula and no intestinal band were noted. The resected appendix measured 4.7 cm in length with normal serosal appearance and covered with congested vessels. On cut section, the appendiceal lumen had minimal blood clots and a prominent vessel was seen at the middle area of the appendix. The histology examination of the appendix revealed serosal congestion secondary to hemangioma/AV malformation.
Recommendation: There were only 18 cases of appendiceal hemorrhage reported in the English literature from 1977 to 2020. To our knowledge, this patient was the 19th case of appendiceal hemorrhage ever recorded and was successfully treated with conventional appendectomy. This case report reminds us that when surveying a patient with lower gastrointestinal bleeding, appendiceal hemorrhage should be taken into consideration, especially in younger patients.
Keywords: appendix bleeding, appendix hemorrhage
Important Dates to Remember
| JRRE Activities 2023-2024 |
Proposed Dates |
|---|---|
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| Monthly Critical Appraisal of Topics Conferences to be gaciliated by Research Coordinators per Institution | Monthly Critical Appraisal of Topics Conferences per Institution |
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